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Ann Saudi Med 28(5) September-October 2008 www.kfshrc.edu.sa/annals 382 Autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia are relatively comm mon in chronic lymphocytic leukemia (CLL), but the presence of both in the same patient is rare. The combination of AIHA and immune thrombocytopenia is known as Evans syndrome which is an idiopathic dism order without an underlying cause.1 Evans syndrome may also develop as a secondary syndrome in associam tion with a variety of conditions like CLL, systemic lum pus erythematosus (SLE) and following autologous or allogeneic stem cell transplantation.2m5 This syndrome can be resistant to a variety of therapeutic measures and associated with significant morbidity and mortality. Rituximab is a monoclonal antibody against CD20 anm tigen present on Bmlymphocytes. It has shown promise in the treatment of many hematologic and nonmhemam tologic immunologic disorders. We present the case of a 68myearmold patient with AIHA and immune thromm bocytopenic purpura (ITP) associated with CLL and discuss the role of rituximab in its management.

Rituximab therapy in a patient with autoimmune hemolytic anemia and immune thrombocytopenia associated with chronic lymphocytic leukemia